HomeMy WebLinkAboutNotice of Loss 21423 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(6171 723-3800 Ma Only(800)392-6108,FAX(800)851-8424
2/18/2023
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch.139, Sec.3B
YARMOUTH BUILDING DEPT .
1146 ROUTE 28 FEB 24 2023
SOUTH YARMOUTH MA 02664 BJ/76/
or: NG��PgRr�F
Re: Insured: WILLIAM F PLANINSHEK
Property Address: 15 LEXINGTON LN,YARMOUTH PORT, MA 02675
Policy Number: 1489635
Type Loss: All Other Section I Losses
Date of Loss: 02/14/2023
Claim Number: 471099
Claim has been made involving loss,damage or destruction of the above captioned property,which may either
exceed$1000.00 or cause Massachusetts General Laws, Chapter 143,section 6 to be applicable. If any
notice under Massachusetts General Laws, Chapter 139, Section 3B is appropriate,please direct it to the
attention of the writer and include a reference to the captioned insured, location,policy number,date of loss
and claim or file number.
MPIUA Claims Division
CMA00021